2854 FREDERICK DOUGLASS BLVD, NEW YORK, 10030, NEW YORK
| Entity Name | SCOTT R. CAPUSTIN, M.D., P.L.L.C. |
| Entity Number | 3178358 |
| Status | ACTIVE |
| Incorporation Date | 17th March 2005 |
| Dos Process Address | 17 HARNESS ROAD, ST. JAMES, 11780, NEW YORK |
| Jurisdiction | NEW YORK |
| County | SUFFOLK |
| Legal form | DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY |